Vaccine
PREGNANCY RECOMMENDATION: Compatible
BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible
PREGNANCY SUMMARY
Poliovirus vaccine inactivated (Salk vaccine, IPV) is an inactivated virus vaccine administered by injection (1). Animal reproductions studies have not been conducted with the vaccine. Although fetal damage may occur when the mother contracts the disease during pregnancy, the risk to the embryo–fetus from the vaccine appears to be low if at all.
FETAL RISK SUMMARY
No adverse effects attributable to the use of the inactivated vaccine have been reported (1,2). The CDC recommends use of the vaccine during pregnancy only if an increased risk of exposure exists (2). If immediate protection against poliomyelitis is needed, the Advisory Committee on Immunization Practices (ACIP) states that the IVP may be used in accordance with the recommended schedules for adults (see reference for specific details) (2).
The Collaborative Perinatal Project monitored 50,282 mother–child pairs, 6774 of whom had 1st trimester exposure to the vaccine (3, p. 315). Congenital malformations were observed in 461 (standardized relative risk [SRR] 1.03). In general, no associations (SRR >1.5) were found (3, p. 318). Specific malformations with SRR >1.5 were: craniosynostosis, 6 (SRR 2.1); atrial septal defect, 6 (SRR 4.0); cleft lip with or without cleft palate, 9 (SRR 1.6); omphalocele, 5 (SRR 2.4); and any malignant tumors, 7 (SRR 3.3) (3, pp. 473–4). For use anytime in pregnancy, 18,219 mother–child pairs were exposed (3, p. 436). A total of 374 newborns had anomalies (SRR 1.08). Specific malformations with SRR >1.5 were: hypoplasia of limb or part thereof, 24 (SRR 1.6); malformations of thoracic wall, 9 (SRR 2.4); anomalies of the teeth, 8 (SRR 2.0); corneal opacity, 5 (SRR 3.5); and CNS tumors, 7 (SRR 17.9) (3, pp. 486–7). The authors of this study cautioned that these data cannot be interpreted without independent confirmation from other studies and that any positive or negative association may have occurred by chance (3).
BREASTFEEDING SUMMARY
No reports describing the administration of poliovirus inactivated vaccine during human lactation have been located (see also Vaccine, Poliovirus Live).
References
1.Linder N, Ohel G. In utero vaccination. Clin Perinatol 1994;21:663–74.
2.CDC. Guidelines for Vaccinating Pregnant Women. Available at http://www.cdc.gov/vaccines/pubs/preg-guide.htm. Accessed May 16, 2010.
3.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977.